An evaluation of day support: A community rehabilitation service?

Day support services are a neglected aspect of promoting the health and social wellbeing of vulnerable adults within the community. Recent policy developments highlight the need to make services more needs-centred and to promote social inclusion. Perceptions of day support provision were explored using quantitative and qualitative questionnaires with clients (54), family carers (7) and a range of health and social services staff (36) and other organisations (10) regarding day support services provided by one Health and Social Services Trust in Northern Ireland. These questionnaires were followed by focus groups to explore key themes. A theoretical framework to shape the evaluation was derived from the work of Maslow and Wolfensberger. A diverse and complex range of health and social care needs were met through day support provision. The engagement of service users seemed patchy in terms of both information provision and consultation. Publicly funded transport was widely regarded as key to accessibility of services. Younger clients did not find current provision attractive, and desired more flexible opening hours. The development of skills for, and support for transition to, employment seemed underdeveloped. For family carers, day support services provided respite that was much valued although clients were not always aware of their family carer's needs. Day support services have an important role within community care, but this is little recognised. Day support services need to be appraised within the context of meeting more complex health and social care needs in the community and emerging policy directions such as the management of risk and the desirability and cost-effectiveness of support for family carers.